https://doi.org/10.31288/oftalmolzh201533035

Clinical efficiency of Helicobacter pylory infection eradication in treatment of patients with chronic central serous chorioretinopathy

Bezditko P. A., Lahorzhevska I. M., Zavoloka O. V. 

Кharkov National Medical University, Kharkov (Ukraine)

Introduction. Central serous chorioretinopathy causes recurrences in 20–50 % of cases and becomes prolonged in 5–10 % of cases that often leads to visual acuity loss. The frequency of Helicobacter Pylory infection among patients with central serous chorioretinopathy is 39.7–86.2 % and exceeds that in general population.

Purpose of the work was to determine the clinical efficacy of Helicobacter Pylory infection eradication in treatment of patients with chronic form of central serous chorioretinopathy. 

Materials and methods. 15 patients with primary chronic form and 36 patients with secondary chronic form of central serous chorioretinopathy participated in this study. Patients were divided into a main group (who were treated with omeprazol 40 mg, claritromycin 1000 mg, amoxicillin 2000 mg in a day for 7–10 days) and a control group (who were not treated). 

Results. In primary chronic form of the central serous chorioretinopathy using Helicobacter Pylory infection eradication in treatment of Hb-positive patients led to increasing positive dynamics with complete resorption of the subretinal fluid in 89 % of patients and improvement of distant prognosis after 2 years: visual acuity increased 1.2 times, decrease of scotoma frequency 1.8 times and scotoma size 3.9 times, decrease of metamorphopsia frequency 2.3 times and color pathology 2.3 times; statistically significant positive dynamics with complete resorption of the subretinal fluid was marked after 6 months in 89 % of patients. Using Helicobacter Pylory infection eradication in treatment of Hb-positive patients in case of secondary chronic form of the central serous chorioretinopathy led to decrease in recurrence frequency by 75 % and improvement of distant prognosis in 2 years: visual acuity increased 1.3 times, decrease of scotoma frequency 1.6 times and scotoma size 1.9 times, decrease of metamorphopsia frequency 1.4 times and color pathology 1.3 times; statistically significant positive dynamics with complete resorption of the subretinal fluid was marked after 6 months in all patients.

Conclusions. Helicobacter Pylory infection eradication is effective in treatment of patients with chronic form of central serous chorioretinopathy.

Key words: central serous chorioretinopathy, chronic form, Helicobacter Pylory.

References

Koskas G, Zurdan A. Comprehensive diagnostics of pathology of the fundus (fluorescent angiography, indocyanine angiography, optical coherence tomography). Neroev V. V., Ryabina M. V., editors. M.: Prakticheskaia meditsina; 2007. 175 p. 

Mostovoi Yu.M., ed. Modern classification and treatment standards for common internal diseases. Edition 6. Vinnytsya; 2004. 463 p. 

Chikovani K. R. Diagnostic criteria and differentiated approach to the treatment of various forms of central serous chorioretinopathy: Thesis for Cand. Of Med. Sc.: 14.00.08. Moscow; 2011. 137 p. 

Abreu R, Nadal J, Abreu P. Helicobacter Pylory and central serous chorioretinopathy. Arch Soc Esp Oftalmol. 2008;83(11):637–8. 
Crossref   Pubmed

Cotticelli L, Borrelli M, D’Alessio AC et al. Central serous chorioretinopathy and Helicobacter Pylory. European journal of ophthalmology. 2006;16(2):274–8. 
Crossref   Pubmed

Casella AMB, Berbel RF, Bressanim GL et al. Helicobacter Pylory as a potential target for the treatment of central serous chorioretinopathy. III CLINICS. 2012; 67(9):1047–52.
Crossref   Pubmed

Piccolino FC, de la Longrais RR, Ravera G et al. The foveal photoreceptor layer and visual acuity loss in central serous chorioretinopathy. Am J Ophthalmol. 2005;139:87–99.
Crossref   Pubmed